Nevada Department of Health and Human Services Forms

This Form is used for applying for a temporary student license in the Radiation Control Program in Nevada.

This Form is used for registering individuals working in computed tomography or fluoroscopy without credentials in Nevada before 01/01/2020. It is part of the Radiation Control Program.

This form is used for changing your name in the Radiation Control Program in Nevada.

This form is used for individuals in Nevada who are working in radiation therapy or radiologic imaging without proper credentials. It is for registration purposes and must be submitted by those who were working without credentials before January 1, 2020. The form is administered by the Radiation Control Program in Nevada.

This Form is used for obtaining a limited license in the Radiation Control Program in Nevada. It allows individuals or organizations to apply for a license to handle and control radiation within the state.

This Form is used for notifying the Radiation Control Program in Nevada about a change of address.

This Form is used for requesting prior authorization for Viltepso in Nevada.

This Form is used for requesting prior authorization for the use of ergot derivatives (specifically Dihydroergotamine) in Nevada.

This form is used for verifying skills in the state of Nevada. It is typically used for employment purposes to ensure that an individual possesses the necessary skills and qualifications for a specific job.

This document certifies the completion of an annual audit monitoring the compliance of manufacturers and wholesalers of drugs, medicines, chemicals, devices, or appliances with the code of conduct in the state of Nevada.

This form is used for patients to participate in the Cancer Drug Donation Program in Nevada.

This form is used for healthcare providers to refer patients who wish to participate in the Cancer Drug Donation Program in Nevada. It helps facilitate the donation of cancer drugs to eligible patients in need.

This document is used for notifying the Cancer Drug Donation Program in Nevada about your intention to participate or withdraw from the program.

This document is used for keeping a record of drug donations, transfers, and destruction within the Cancer Drug Donation Program in Nevada.

This type of document is used by physicians in Nevada to apply for authority to dispense drugs.

This document is for applying to become an Advanced Practitioner of Nursing with dispensing privileges in Nevada.

This document is for individuals seeking training as a technician in Nevada for dispensing medication.

This form is used to apply for a Physician's Assistant license in Nevada with dispensing privileges.

This document is for Advanced Practice Registered Nurses in Nevada who want to apply for prescribing privileges.

This document is an application form for individuals in Nevada who wish to become a Physician's Assistant and have the authority to prescribe medications.

This type of document is an application for veterinarians in Nevada to obtain authority to dispense drugs. It allows veterinarians to legally prescribe and distribute medications for animal patients.

This document is an application form for individuals who own non-practitioner dispensing sites in the state of Nevada. It is used for applying for a license to operate and dispense certain types of medications or pharmaceutical products.

This document is an application form for individuals in Nevada who are interested in becoming euthanasia technicians.

This document is used for submitting complaints about pharmacies in Nevada. It allows individuals to report any issues or concerns they have regarding medication, service, or operations of a pharmacy.

This form is used for reporting an adoption in the state of Nevada. It is submitted to document the legal process of adopting a child.

This document is a Certificate of Medical Vaccine Exemption for schools and universities in Nevada. It is used to provide proof of a medical exemption from required vaccinations.

This document is used for obtaining a medical immunization exemption certificate for colleges in Nevada.

This document is for religious immunization exemption certificate for colleges in Nevada. It is used to request an exemption from immunization requirements based on religious beliefs.

This type of document is a "Certificado Excepción Religiosa De Vacunas" for universities in Nevada. It is a certificate that exempts individuals from vaccine requirements based on religious grounds.

This document is for certifying religious exemption from vaccines in Nevada.

This document for signing in to a course in the state of Nevada.